Healthy Breasts: What Everyone Should Know

Healthy Breasts: What Everyone Should Know

October is National Breast Cancer Awareness Month. Throughout the month, organizations from non-profits to government agencies to health-conscious companies are working to raise awareness of this disease. Here’s our contribution to helping women (and men too) of all ages learn how to take control of their own health.

Illustration by Shannon Orcutt

One in eight women will be diagnosed with breast cancer during their lifetime. In the United States, 220,000 women and 2,150 men are diagnosed with the disease each year. The good news? As with any cancer, early detection saves lives. With education about how to identify potential symptoms, men and women can learn preventative behaviors and early detection skills.

So what puts you in the line of fire? Some breast cancer risk factors are inherited or result from uncontrollable factors like age or race. Many other risk factors are tied to lifestyle. People with several preexisting risk factors (see below) should exercise, stick to a healthy diet, and not smoke to reduce the chance of developing the disease. Here are some of those preexisting factors:

Gender. While male breast cancer is possible, it occurs nearly 100 times more often in women. Men make up 1 percent of all breast cancer diagnoses.

Race. Caucasian women are the most likely to develop breast cancer, although the disease is on the rise in African-American women. In general Asian, Hispanic, and Native American women are less likely to get breast cancer than women of other races.

Family health history. Between 5 and 10 percent of all diagnosed breast cancers are due to genetic mutations. People with a parent, child, or sibling who has been diagnosed are more likely to develop the disease, because they may have a hereditary mutation on the BRAC1 and BRAC2 genes Identification of the breast cancer susceptibility gene BRCA2. Wooster R, Bignell G, Lancaster J, Swift S, Seal S, Mangion J, Collins N, Gregory S, Gumbs C, Micklem G. Section of Molecular Carcinogenesis, Haddow Laboratories, Sutton Surrey, UK. Nature. 1195 Dec 21-28;378(6559):789-92. In some families with this genetic mutation, the risk for breast cancer can be as high as 80 percent. If breast cancer runs in the family, a genetic test can tell if you have this mutation.

Menstrual and reproductive history. Women who experienced early menstruation (before age 12) or late menopause (after age 55) are at higher risk. Women who give birth at age 35 or older or do not have children are also at higher risk. Having gone through menopause also increases risk, as can the associated medications, like combined hormone replacement therapy. Some studies also show that breastfeeding (especially for longer than a year) can lower risk of developing breast cancer.

Dense breast tissue. Women with denser breasts (made up of less fat and more glandular tissue) are more at risk because the composition of the tissue makes it more difficult to detect lumps with a self-exam or mammogram. Ultrasound or breast MRI are usually the go-to methods for keeping tabs on breast health in women with dense breast tissue.

Lack of physical exercise. A sedentary lifestyle can increase risk, while exercising regularly can lower it.

Poor diet. A diet high in saturated fats and low in fruits and vegetables can make people more likely to develop breast cancer. Stock up on antioxidant-rich produce to lessen risk. Being overweight or obese can amplify risk factor, too.

Drinking habits. Boozing too hard can increase risk of getting breast cancer. But sipping one glass of antioxidant-rich wine a few nights a week can actually reduce risk of cancer — just don’t go too far. Studies show premenopausal women who consume more than 27 drinks each week and postmenopausal women sipping on more than six drinks per week are more likely to develop breast cancer than their teetotaling peers Alcohol intake, type of beverage, and risk of breast cancer in pre- and postmenopausal women. Petri AL, Tjonneland A, Gamborg M, Johansen D, Hoidrup S, Sorensen TI, Gronbaek M. Copenhagen Centre for Prospective Population Studies, Danish Epidemiology Science Centre at he Institute of Preventative Medicine, H:S Kommunehospitalet, Copenhagen University Hospital, Copenhagen, Denmark. Alcohol, Clinical and Experimental Research, 2004 Jul; 28(7):1084-90..

Being a smoker.Smoking not only causes lung, throat, and mouth cancer, but can also make people more susceptible to other diseases like cervical or breast cancer. Quitting ASAP provides many health benefits, including a lower risk of contracting breast cancer.

Why Should I Care About Breast Cancer Now?

Young ladies, listen up: Although only about seven percent of breast cancer cases occur in women under the age of 40, it’s best to gain awareness of the disease early. The chance of a 20-something woman getting breast cancer is 1 in 2,000. That risk increases for 30-something women to 1 in 250. But because young women are less likely to do regular self-exams, go for mammograms, and head to the doctor if they detect a lump, breast cancer in young women is often detected in much later, more aggressive stagesEpidemiology of breast cancer in young women. Yankaskas BC. Department of Radiology, University of North Carolina at Chapel Hill, USA. Breast Dis. 2005-2006;23:3-8.. Young people and even teenagers with a family history of breast cancer, early exposure to radiation to the chest, or the BRCA1/BRCA2 gene mutation should begin preventative strategies early. (But even young women without preexisting risk factors should get in the habit of doing a monthly check, just to be safe.)

Pink ribbons and all, breast cancer is usually considered a women’s disease. But it can affect men, and not only dudes with “moobies.” Less than one percent of all cases occur in men, but male breast cancer has a higher fatality rate because it is so uncommon and more likely pass under the radarEpidemiology of male breast cancer. Department of Epidemiology, Roswell Park Cancer Institute, Buffalo, NY. Cancer Epidemiololgy, Biomarkers, and Prevention. 2005 Jan; 14(1):20-6.. So how can men get breast cancer if they don’t have breasts? Although guys don’t usually frequent Victoria’s Secret, they do have breast tissue that can be susceptible to breast cancer. Like with young women, the most common risk factors for guys are exposure to chest radiation, high levels of estrogen, and genetics. Men with hereditary predisposition to breast cancer (aka those darned BRCA mutations or other wonky genes) are also more likely to develop prostate cancer at an earlier age.

The First Line of Defense — How to Do a Self-Exam

Time to get up close and personal with your chest (boys, you too.) Performing a monthly self-exam can save lives: According to Johns Hopkins Medical Center, 40 percent of diagnosed breast cancers are detected after women who feel a lump take their concern to a doctor.All women over the age of 20 should take time to do a thorough check each month. Copping a feel every once in a while also teaches each woman what’s normal for her breasts, which is useful knowledge to have when paying a visit to the doctor. Because things tend to change shape and size throughout the stages of the menstrual cycle, it’s a good idea to check things out around the same time of the month.

Illustration by Shannon Orcutt

All adult women should take time once a month to perform a thorough self-examination. Here are five easy steps to follow for a comprehensive self exam.

1. Stand in front of a mirror with shoulders straight and hands on hips. Check that breasts and nipples are their usual size, shape, and color. There should be no swelling, redness, or puckering/distortion.

Using the pads of your three middle fingers, move your hand in small circular motions around the breast. Continue the process over the entire area — from clavicles to rib cage and from armpit to cleavage. Use different amounts of pressure, starting the each area with light touch and progressing to deep pressure before moving on to the next spot.

5. Try the lie-down check while in the tub or standing in the shower. Water reduces friction and makes it easier to feel small irregularities.

Not a fan of the circular pattern? You can also work in a vertical or “wedge” pattern when preforming your self check. For the vertical method, check the entire breast area in finger-width vertical strips moving from top to bottom, and bottom to top. For the wedge method, divide the breast into pie-slice shaped sections and check one wedge at a time.

Uh Oh — How to Know When Is Something Is Wrong

If there are any changes in how the breast or nipple looks or feels, head straight to the MD. Some tenderness around that time of the month is normal, but anything persistent or unusual could be cause for concern. Keep an eye out for nipple pain or tenderness, nipple retraction (when they suddenly turn inward instead of outward), redness or scaliness, unexpected swelling or shrinkage of the nipple or breast, discharge when not breastfeeding, swelling, prolonged pain, skin dimpling or puckering, or a change in skin texture (especially enlargement of the pores). Some early signs of breast cancer are visual, so definitely check yo’self every so often.

Feeling a lump doesn’t always mean cancer, either.Cysts — small, often benign fluid-filled sacs that can develop in some breast tissue, sometimes due to hormonal changes over the course of a month — can feel like lumps during a self-exam, but they’re harmless. The only way to tell the difference between a cyst and a tumor is to get an ultrasound at the doctor’s office, so if you feel something’s wrong, head to the doctor anyways. Having a cyst (or even a lot of cysts) is likely not breast cancer. In fact, sometimes they’re the norm. Women who get cysts regularly should regularly perform self-exams to learn what is “normal” for their breasts. Chat with a doc about the best way to stay vigilant about lumps and bumps if you’re prone to developing cysts.

In general, don’t freak out if things get tender in the chest department — breast pain is not usually a symptom of breast cancer. Most of the time, tenderness is due to the hormonal rollercoasters of puberty, menstruation, pregnancy, breastfeeding, and also certain medications. Pain can be a sign of Inflammatory Breast Cancer, so if pain exists in one small spot and doesn’t go away, head to the doctor to get things checked out.